Corsets and Rib Removal

This week is an update on corsets and rib removal (rib resection being the proper term for it), because this surgical procedure has been circulating in the news again recently. Back in 2012, I believe I said that there was no medical documentation of anyone in the no one past or present had ever surgically broken or removed their floating ribs for purely aesthetic purposes, and I turned out to be mistaken! Pixee Fox (The Living Cartoon) had three pairs of ribs removed in 2015, and more recently Rodrigo Alves had two pairs removed in late 2017. Since both of them habitually wear corsets, many people have emailed and messaged me to ask my take on this, so this gives me the opportunity to correct what I stated 5-6 years ago.

Why Did I Doubt Cosmetic Rib Resection Before?

I originally got this information from Chapter 10 of Victorian Secrets by Sarah A Chrisman (it’s still an excellent memoir on corsets and waist training otherwise), and also from Valerie Steele’s book The Corset: A Cultural History which was published in 2001. At the time, Steele couldn’t find any official publication from the 19th or 20th centuries regarding elective cosmetic surgery to remove the ribs:

“Historians sometimes claim that rib removal occurred, but without providing evidence, or they hedge their bets by mentioning the ‘rumor’ that certain women had this operation … It would have been very difficult for a woman to find a trained surgeon willing to undertake such a hazardous operation for cosmetic purposes. Histories of plastic surgery to not mention rib removal.

“Rumors of movie stars having their lower ribs removed still circulate. It would now theoretically be possible to perform such an operation, and someone somewhere may have done it. ‘But there’s never been anything published about it; no one has owned up to performing such a procedure, much less to having had one,’ says Dr. John E. Sherman of Cornell University’s medical school.” (Steele, 2001, p 73-74)

This was obviously in specific context to rib resection as a purely cosmetic surgery, however. Nobody doubts that rib resection has been used for various medical purposes.

Medically Necessary Reasons for Removing the Ribs Today

• If someone breaks a rib by injury, or has a congenital condition that led to severely deformed and rotated ribs, and there’s a chance it might never be corrected (in the case of broken ribs, they might never heal properly), sometimes the surgeon believes it’s better for the patient to remove it.
• If there is any cancer that spreads to the bone and it cannot be effectively treated by other measures like chemotherapy or radiation, the bone is amputated.
• The ribs can also be removed to use in reconstructive surgery in smaller parts of the body. A common place to use these bones is in the face and jaw (after a bad injury or oral cancer, etc.) because using your own tissue is said to have a lower chance of rejection or reaction, compared to titanium plates and the like.
• Sometimes the upper ribs are removed for medical purposes: the first rib (close to the clavicle (aka collarbone) can be removed in hopes of correcting Thoracic Outlet Syndrome, blood clots in the neck and shoulder, Reynaud’s Syndrome, or other medical complications that might arise from nerves or blood vessels growing around the bones of this area above the collarbone. Some people even have little vestigial cervical ribs that grow out of the neck (this is rare – like being born with a tail).
• There are also many open surgeries where the ribs are temporarily broken or removed to get at the heart, lungs or kidneys, and then the surgeons usually put the ribs back again.

You can read more about the more common reasons for rib resection on this site.

However, Victorians Did Not Remove Their Ribs

The idea that millions of women in the 1800s removed their floating ribs for the sake of vanity is absurd. This was a time before anesthetic was able to be calibrated based on a person’s size and weight – at the time, ether or chloroform was used as anesthetic, and depending on how much was administered to the patient, there was a risk of them either waking up in the middle of surgery, or never waking up again.

Puncturing a lung and causing it to collapse was also very real risk (and is still a risk today) because you’re working so closely to the area, trying to separate bone from the intercostal muscles that lie overtop of the lungs.

Also, people didn’t know about blood types until around the year 1900 – if a patient lost too much blood and needed a transfusion, it was a game of roulette to find a donor that would match their blood type (if one could find a donor fast enough at all).

Germ theory was only really starting to be accepted around the 1880s, so before this time, many surgeons would not sterilize their tools or even wash their hands. Even if a physician were an early adopter of germ theory and did learn the importance of hand washing, it would still be about 50 years before penicillin would be discovered in 1928 (and even then, it wasn’t officially medically distributed until closer to 1940). So infections, complications, and fatalities associated with any surgical procedure (medically necessary or not) were still extremely high.

Remember that surgical procedures were so feared that as recently as WWI, among those who needed life-saving surgery, many opted for death instead – so the idea of many women to voluntarily opt for cosmetic surgery around this time is simply ridiculous and not based in fact.

In fact, a lot of rumors about Victorian period (rib removal surgeries, tightlacers’ spines breaking in half when not supported by a corset, forced tightlacing to 12″ waist circumference by strict school headmistresses, etc.) were actually stories from 19th century fiction pieces and fetish magazines. People forget that fanfiction was still a thing a few centuries ago; not every surviving publication from the era was documented fact. (A great documentary to learn more about the gruesome history of surgery is one called Blood and Guts, a History of Surgery).

Also worth mentioning: a sizeable number of surviving photographs from the Victorian and Edwardian eras have been edited (essentially an early form of “Photoshop”) by painting over parts of the negatives to make women’s waists look smaller, more tapered, and more extreme than they really were. Karolina Żebrowska did a great video explaining this (and giving a very easy modern example), which you can watch here.

When Did Cosmetic Rib Removal Start Getting More Popular?

According to Steele’s book (as of 2001), rib resection as a purely elective cosmetic surgery was not something that had been medically documented before. While there are countless rumors of various celebrities having their ribs surgically removed (Cher, Marilyn Manson, Cindy Crawford, etc.) they have never been medically verified… but from my research, around 2006-2007-2008, rib removal has been discussed as a procedure for trans women to create a more narrow torso and waistline.

Here is a video from 2011 by Dr. Aaron Stone performing a tummy tuck, liposuction and rib removal on one patient to create a smaller waist (content warning: very graphic – blood, muscle and bone tissue clearly visible, as well as some genitals).

However, the procedure is invasive that most doctors will not consider performing it. Some patients claimed to fly down to South America to have it performed, as they were hard-pressed to find doctors in Europe or North America willing to do it. And it goes without saying that the surgery carries all the same risks as other major surgeries: risk of reaction to anesthesia, infection, sepsis, problems healing, etc. (And there’s still a risk of collapsing a lung during the surgery and then you’d have to re-inflate it.)

Notable (and Documented) Cases of Cosmetic Rib Removal

We can’t have a comprehensive article on modern rib removal without talking about arguably the most famous case of cosmetic rib resection, which was performed on Pixee Fox, who is another corset enthusiast!  For her “living cartoon” project, she had 3 pairs of ribs removed in 2015 (the four floating ribs and a pair of false ribs above them), which allowed her to cinch her waist down further in her conical-rib corsets. More accurately, according to Fox’s surgeon, her ribs were not fully removed but rather shortened, as he explained in this interview in 2016.

The two lowest ribs (11th and 12th ribs) are “floating” and don’t wrap fully around the ribcage to begin with. If you look at a skeleton, the bottom two sets of ribs are only connected at the back, and can swing like hinges in and out with your breath. According to Fox’s surgeon, he shortened her ribs by removing the cartilage tips on the sides but left part of ribs in the back, around the kidney area.

Another documented case of voluntary rib removal was performed on Rodrigo Alves who had two pairs of ribs (the floating ribs) removed. To prove that it was real, the consultation and surgery streamed on Alves’ Instagram, and Alves was allowed to take home and keep his removed ribs in a jar. Click here for an interview with Alves on This Morning (content warning: his removed ribs are shown around 30 seconds into the interview).

My Opinions on Cosmetic Rib Removal

If you’ve followed me for long enough, you know that I prefer to report objectively on corset-related news; especially when it comes to health and medical cases relating to corsetry. However, there was an overwhelming number of requests for my my personal opinion on Pixee Fox and Rodrigo Alves after reading their recent stories in the media. Let me be clear: asking me to gossip and share my personal opinions of people I’ve never met is not very classy.

Regarding my opinion of cosmetic rib removal of the procedure itself: It is not something I would ever consider, and I don’t find it necessary because corsets are able to shift the ribs very dramatically over years or decades (as in the case of Cathie Jung).

Of course having your ribs surgically removed is not an average procedure, and both Pixee and Rodrigo have said that they were never going for average – both of them have said in interviews, in their own way, that they prefer to stand out: they are not aiming to look like anyone else, and they’re each setting records and pushing the limit as to what plastic surgery is able to do. While I wouldn’t recommend removing ribs for purely aesthetic reasons, it’s really not my place to say to other people “Hey, you’re not allowed to do that with your body!” because their body is not mine to begin with.

Considering how difficult it is to spread the message that corsets are capable of promoting self-esteem and body-image, they can be empowering and are a strong expression of bodily autonomy, it would be especially hypocritical of me to drag anyone for having a procedure that they researched thoroughly, responsibly consulted with professionals, and really, really wanted for themselves. I am less familiar with Alves’ experience (partially because it’s so recent), but it is obvious that Pixee Fox had done plenty of research and was aware of the risks; she sought many professional opinions on rib removal before going through with it, as was evident by the fact that so many doctors refused to perform the procedure before she found one that was willing.

Moreover, I have never heard Fox pressure her followers to do the same; she’s never said, “Hey everyone, you all NEED to do this!” Rather, she always says in her interviews, “I’m doing right by me, and you should do right by you.”

Regardless, the procedure is finished and what’s done is done. I’m happy that the operations seemed to have gone well for all three medically documented cases (the trans woman in 2011, Pixee Fox in 2015, and Rodrigo Alves in 2017).

My final word regarding my opinion on all of this: it’s not something I would ever consider, but my opinion is irrelevant. For people who have already gone through with this surgery, whether they’ve “gone public” with it or not – from what I can see they’re not committing any harm to others, and so they deserve the same amount of respect as anyone else.

Creating a Smaller Waist and Ribcage Using Corsets

It is entirely possible to achieve a small corseted waist without surgery – Cathie Jung has been wearing corsets for some 40 years, and has a 15 inch waist underneath her corsets – if you look at her X-rays, you’ll see that she has all 12 sets of ribs; they’ve just been contoured and formed over decades of training.

You can also see the same in the skeletons of women who waist trained in the 1800s, and even Rebecca Gibson’s studies of impoverished French women in the 19th century showed that they experienced some tapering of the ribs as well.

So it is possible to achieve an extreme shape with corsets and creating a tapered ribcage with a conical rib corset, while still keeping all your ribs. It does take many many years (possibly decades for some), and it does require that one has a relatively flexible ribcage (flexible costal joints, where the ribs connect to the spine) to begin with. Some people have extremely rigid ribs and don’t tolerate compression on their ribs at all (their ribs would rather bruise than move). With this in mind, I suppose that the motivations of some people for going forward with surgery are:

1. they don’t want to wait years / decades for results, and
2. they may have a very rigid ribcage and are physically unable to compress their ribs using corsets.

In conclusion, I wanted to come round and confirm that:

• Rib removal / rib resection is a real surgery.
• It is used more commonly for correcting pre-existing medical problems or for reconstructive surgery in other parts of the body.
• It can be performed as a cosmetic procedure on its own, but it is still relatively rare (and secretive) and most surgeons do not recommend it.
• It’s not a procedure I would consider for myself / widely condone.
• It was certainly not successfully done in the Victorian era; there were too many risks and medicine was not that refined enough.

I hope this cleared up some common misconceptions about rib removal. What do you think of the myths and truths surrounding the procedure? Have you experienced tapering of your ribs from corsets? Leave a comment below!